Presentation
A left supraclavicular mass of 3 years duration gradually increased in size and became painful in the past 6 weeks.
Patient Data
An irregular shaped tortuous signal void high flow vascular channels at the Lt. supraclavicular region with surrounding soft tissue edema. The lesion contains bilocular thrombosed aneurysmal dilatation of high signal intensity margin and low signal intensity center on T1WIs and low signal intensity margin and high signal center on T2WIs with non-uniform contrast enhancement in post-contrast examination.
Prominent tortuous left thyrocervical trunk, costocervical trunk, supraclavicular and ascending cervical arteries.
The high flow arteriovenous malformation with central thrombosed aneurysm (non-enhancing post-contrast). Multiple enlarged vascular channels and enlarged thyrocervical trunk (the feeding artery).
Case Discussion
Vascular malformations are believed to be present at birth but may not become apparent until later in life. Intrinsic Vascular malformations occur in 1.5% of the population.
The most common localization of arteriovenous malformation is intracranial. Brain malformations are about 20 times more frequent than extracerebral ones.
MRI and CT angiography provides three dimensional (3D) reconstruction of this entity at the root of the neck and helps to differentiate it from the commoner lymph nodal enlargement, with a precise evaluation of nidus and extension which facilitates preoperative surgical planning and for providing an intraoperative reference.